Redelmeier D A, Weinstein M C
Department of Medicine, University of Toronto, Sunnybrook and Women's College Health Sciences Centre, Ontario, Canada.
Med Decis Making. 1999 Jan-Mar;19(1):1-8. doi: 10.1177/0272989X9901900101.
To evaluate the cost-effectiveness of regulations that prohibit using a cellular telephone while driving a motor vehicle.
Decision analysis of risks and benefits related to cellular telephones and driving.
United States population in 1997.
Health benefits measured as the quality-adjusted life years potentially saved. Financial benefits measured as health care and other services potentially averted. Costs of regulation measured as the lost productivity derived from willingness to pay for cellular telephone calls.
Under base-case conditions, cellular telephone calls in the United States each day accounted for about 984 reported collisions, 1,729 total collisions, 2 deaths, 317 persons with injuries, 99 lost years of life expectancy, 161 lost quality-adjusted life years, $1 million in health care costs, and $4 million in property damage and other costs. This reflected a total of about 35 million telephone calls while driving, 70 million calling minutes, and $33 million in total value to society. The estimated cost-effectiveness ratio for a regulation restricting cellular telephone usage while driving was $300,000 per quality-adjusted life year saved, but ranged from $50,000 to $700,000 under alternative assumptions and interpretations of data. Regulations applied to teenage males could be cost-saving to society if the value of a call fell below 37 cents per minute.
Regulations restricting cellular telephone usage while driving are less cost-effective for society than other safety measures. Nevertheless, regulations may be justifiable because the benefits and harms do not always involve the individual who has the cellular telephone. Increasing the price of a call (or adding a supplementary tax) might decrease the number of discretionary calls, be cost-saving for society, and be life-saving for individuals.
评估禁止在驾驶机动车时使用移动电话的法规的成本效益。
对与移动电话和驾驶相关的风险和益处进行决策分析。
1997年的美国人口。
健康益处以可能挽救的质量调整生命年衡量。经济益处以可能避免的医疗保健和其他服务衡量。法规成本以因愿意支付移动电话通话费用而导致的生产力损失衡量。
在基本情况下，美国每天的移动电话通话导致约984起报告的碰撞事故、1729起总碰撞事故、2人死亡、317人受伤、99年预期寿命损失、161个质量调整生命年损失、100万美元医疗保健成本以及400万美元财产损失和其他成本。这反映出驾驶时总共约3500万个电话通话、7000万通话分钟以及对社会的总价值3300万美元。限制驾驶时使用移动电话的法规的估计成本效益比为每挽救一个质量调整生命年30万美元，但在数据的替代假设和解释下，范围为5万至70万美元。如果通话价值低于每分钟37美分，适用于青少年男性的法规可能对社会具有成本节约效益。
限制驾驶时使用移动电话的法规对社会而言，成本效益低于其他安全措施。然而，法规可能是合理的，因为益处和危害并不总是涉及拥有移动电话的个人。提高通话价格（或征收附加税）可能会减少随意通话的数量，对社会具有成本节约效益，并对个人具有挽救生命的效益。
